Alimohamadi Yousef, Zahraei Seyed Mohsen, Karami Manoochehr, Yaseri Mehdi, Lotfizad Mojtaba, Holakouie-Naieni Kourosh
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran.
Med J Islam Repub Iran. 2020 Mar 18;34:22. doi: 10.34171/mjiri.34.22. eCollection 2020.
In spite of existing vaccination programs in many countries, outbreaks of pertussis are still reported. In Iran, the suspected and confirmed cases of pertussis are reported annually. Due to the lack of similar studies, the purpose of the current study was to determine the Spatio-temporal distribution of Pertussis using Geographic Information System (GIS) to identify high-risk areas in Iran during 2012-2018. In the current cross-sectional study, registered data in the department of vaccine-preventable diseases in the Iranian ministry of health were used. To assess the temporal trend, the Cochran-Armitage test was used. To show the spatial distribution and to identify hotspot areas, Choropleth map and Getis-Ord Gi statistics were used. All analyses performed by Arc.map10.5, Stata 15 and Excel 2010. The incidence of suspect pertussis cases had an increasing trend but did not have a linear trend (p=0.06). Most of the cases happened in under 1 year infants (62.66%). The incidence of reported cases in northern areas was higher than in the Southern areas. The Zanjan had the most reported cases during the understudied period with a median of 7.63 reported cases per 100,000. The clustering of infection and hotspots were identified in northern areas of Iran including Qazvin, Qom, Markazi, and Hamadan. Our results showed that the cumulative incidence of reported cases is increasing. The northern provinces had the highest incidence of Pertussis. Therefore, the causes of this spatio-temporal pattern of pertussis should be determined. Also, supervision on vaccination programs in high-risk areas is recommended.
尽管许多国家都有现有的疫苗接种计划，但仍有百日咳疫情报告。在伊朗，每年都会报告百日咳疑似和确诊病例。由于缺乏类似研究，本研究的目的是利用地理信息系统（GIS）确定2012 - 2018年期间伊朗百日咳的时空分布，以识别高风险地区。在当前的横断面研究中，使用了伊朗卫生部疫苗可预防疾病部门登记的数据。为评估时间趋势，采用了 Cochr an - Armitage检验。为展示空间分布并识别热点区域，使用了分级统计图和Getis - Ord Gi统计量。所有分析均通过Arc.map10.5、Stata 15和Excel 2010进行。疑似百日咳病例的发病率呈上升趋势，但无线性趋势（p = 0.06）。大多数病例发生在1岁以下婴儿（62.66%）。北部地区报告病例的发病率高于南部地区。在研究期间，赞詹报告的病例最多，每10万人中报告病例的中位数为7.63例。在伊朗北部地区包括加兹温、库姆、马尔卡齐和哈马丹发现了感染聚集和热点区域。我们的结果表明，报告病例的累积发病率在上升。北部省份百日咳发病率最高。因此，应确定百日咳这种时空模式的原因。此外，建议对高风险地区的疫苗接种计划进行监督。
